Project Summary End-Stage Renal Disease (ESRD) affects just over 600,000 people in the United States and costs Medicare ~$33 billion annually. In-center thrice-weekly hemodialysis is the most commonly performed treatment for ESRD, but it suffers from poor 5-year survival rates, reduced patient quality of life, and is costly. In contrast, frequent hemodialysis has demonstrated 5-year survival rates similar to kidney transplant and has improved intermediate outcomes. Even though frequent hemodialysis yields superior outcomes than in-center thrice- weekly hemodialysis, it is performed by less than 1% of the ESRD population because it is too costly to perform in-center and too complex to perform at home. Current home hemodialysis systems require patients and caregivers to perform complicated tasks associated with life threatening risks, such as self-care needle sticks. The superior outcomes but low adoption rate of frequent home hemodialysis creates an opportunity for a simple-to-use and safe home hemodialysis system. The long-term objective of our project is to create a new home hemodialysis system (the iHemo) that will increase the practice of frequent home hemodialysis and improve End-Stage Renal Disease (ESRD) outcomes.